The ever tenser physician-patient relationship is one of major social problems in present China,thus the construction of a harmonious physician-patient relationship is one important part in constructing a harmonious society.Medical social workers' involvement into the current physician-patient relationship from the perspectives of case social work,group social work,community social work,and social policy making will serve as a positive motivation for the development of a harmonious physician-patient relationship.

AIM:To investigate the reasonableness test of different parts of Herba Asari.METHODS:HPLC method was used to determine aristolochic acid A content content in different parts of Herba Asari.RESULTS:Aristolochic acid A content in above-ground parts of Herba Asari was higher than that in the root,and aristolochic acid A was not detected ever in some Radix et Rhizoma Asari.CONCLUSION:It is more reasonable that the medicinal part of Herba Asari is selected from the root rather than whole herb,and it is coincident with medicinal literature.

Objective To study a simple?minimally invasive?safe?effective and economical therapy for osteoportic vertebrae compression fracture. Methods 9 patients with 14 vertebrae (13 lumbar, 1 thoracic) suffered from osteoportic compression fractures were treated with percutaneous vertebrolasty from March to September in 2001. The patients included 8 women and 1 man aged from 33 to 85 years with a mean of 72 years. Results All patients had marked to complete pain relief at 1～2 postoperative days, and could get up to move at 2～3 postoperative days. During 1-6 months follow-up period, no pain reoccurred. No severe comlication occurred. Conclusions Percutaneous vertebroplasty provided significant pain relief in the patients with osteoportic vertebrae compression fractures. It is a promising therapy for patients with osteoportic vertebrae compression fracture.

BACKGROUND:Articular cartilage injuries can result from a variety of causes. Conventional therapy cannot obtain the optimal clinical results. Low-intensity pulsed ultrasound has been shown to promote the repair of injured articular cartilage. OBJECTIVE:To investigate the effects of low-intensity pulsed ultrasound on the repair of injured articular cartilage. METHODS:Twenty New Zealand white rabbits were used to establish knee arthritis models and equal y randomized into study and control groups, respectively. Rabbits in the study group received low-intensity pulsed ultrasound treatment, and sham low-intensity pulsed ultrasound treatment was given in the control group. At 8 weeks after treatment, pathological change and histological scores in articular cartilage tissue col ected from both groups were determined. Moreover, the ultrastructure and type II col agen expression of chondrocytes were determined. Matrix metal oproteinase-13 mRNA expression was detected by quantitative real-time PCR. RESULTS AND CONCLUSION:At 8 weeks after treatment, toluidine blue staining showed a disordered arrangement of cel s, decreased number of cartilage cel s in each layer and cluster in the control group. Light disordered arrangement of cel s, decreased appearance of the superficial layer cel s and the cluster phenomenon were observed in the study group. Articular cartilage tissue scores were significantly decreased in the study group compared with the control group (P<0.05). The chondrocytes were smal , enlarged intracel ular mitochondria and rough endoplasmic reticulum, cytoplasmic swel ing, col agen fibrils coarse, wel developed Golgi apparatus, and nuclear fragmentation were observed in the control group. In addition, the normal structure of organel es disappeared and cel degeneration was observed in the control group. In the study group, the size of chondrocytes and the Golgi complex and other organel es were normal, and the protein polysaccharide granules were observed in the cytoplasm and membrane. The mRNA expression of matrix metal oproteinase-13 in the study group was significantly lower than that in the control group (P<0.05). Type II col agen immunoreactivity in the study group was stronger than that in the control group. No incision infection, suppuration, red swel ing appeared in al rabbits. Our results suggest that low-intensity pulsed ultrasound can be used for the treatment of articular cartilage injury by al eviating the degradation of col agen type II and inhibiting the expression of matrix metal oproteinase-13.

OBJECTIVE:To optimize the extraction technology of total saponins from Coreopsis tinctoria. METHODS:Etha-nol leaching technology was adopted. Based on single factor test,the extraction technology was optimized by orthogonal test using extraction temperature,ethanol volume fraction,extraction time,solid-liquid ratio as factors,extraction rate of total saponins as in-dex. The optimized technology was validated. RESULTS:The optimal technology was that ratio of solid to liquid was 1:30 (C. tinctoria-60% ethanol),extracting for 2 h at 50 ℃. Validation test showed that average extraction rate of total saponins was 6.8%(RSD=0.85%,n=3). CONCLUSIONS:The optimized technology can be used for the extraction of total saponins from C. tinc-toria and keep stable.

Objective To investigate the value of ultrasound in typing of epididymal tuberculosis on the clinical treatment . Methods The sonographic characteristics and treatment outcomes were analyzed in 125 patients with epididymal tuberculosis . Results In 125 patients with epididymal tuberculosis ,5 types were divided:( 1 ) Diffusive type ( 37 cases ) presented images of the epididymal diffuse enlargement , abnormal shape ,not smooth surface and inhomogeneous reduced in echogenicity ,13 cases were treated conservatively and 24 cases underwent surgical treatment after failure of conservative treatment . (2) Mass type (24 cases) showed images of hypoechoic mass lesion of caput epididymidis or cauda epididymidis ,4 cases were treated with surgical operation and 20 cases were treat with conservative therapy . (3) Abscess type ( 33 cases) manifested images of irregular liquid anechoic of caput epididymidis and cauda epididymidis , poor ultrasound penetration ,and unclear border . (4) Ulcer‐fistula type (9 cases) revealed images of liquid hypoechoic caput epididymidis or cauda epididymidis extend to the surface of the scrotum . ( 5) Testicular involvement type (22 cases) detected inhomogeneous hypoechoic mass lesion within the testicle and unclear border . The patients of abscess type ,ulcer‐fistula type and testicular involvement type were all treated surgically . Conclusions Ultrasonic diagnosis of epididymal tuberculosis provided a reliable basis for clinical treatment scheme and it was worth recommending .

Objective T o evaluate the application value for the prognosis of m echanical ocular injury cases using ocular traum a score (O TS). Methods Four hundred and eleven cases of m echanical ocular traum a w ere retrospectively review ed. O f the 449 eyes, there w ere 317 closed globe injury and 132 open globe injury. O T S variables included num erical values as initial visual acuity, rupture, endophthalm itis, perforat-ing or penetrating injury, retinal detachm ent and relative afferent pupillary block. T he differences be-tw een the distribution of the final visual acuity and the probability of standard final visual acuity w ere com pared to analyze the correlation betw een O T S category and final visual acuity. T he different types of ocular traum a w ere com pared. Results C om pared w ith the distribution of final visual acuity in standard O T S score, the ratio in O T S-3 category w as statistically different in present study, and no differences w ere found in other categories. Final visual acuity show ed a great linear correlation w ith O T S category (r=0.71) and total score (r=0.73). C om pared w ith closed globe injury, open globe injury w as generally associated w ith low er total score and poorer prognosis. R upture injury had poorer prognosis com pared w ith penetrating injury. Conclusion T he use of O T S for the patients w ith ocular traum a can provide re-liable inform ation for the evaluation of prognosis in forensic m edicine.

Objective This study aimed to develop reading material for nasalance evaluation ,and find out na-salance scores associated with genders .Methods The NasalView ? (Tiger Electronics Inc .,Seattle ,USA) was used to obtain nasalance values in the new and old material .A total of 102 subjects (51 males ,51 females) who have lived in Beijing for 18 years or longer at the time of the experiment received the tests ,the results from two pieces of material and the mean nasalance gender score differences were compared .Results The mean nasalance scores of sen-tences were 56 .58% ± 3 .43% for'Nasal sentence',33 .86% ± 5 .24% for'Oral sentence',and 49 .49% ± 4 .13% for'Oro -nasal sentence'respectively in the new material .The mean nasalance scores of sentences were 54 .31% ± 4 .43% for'Nasal sentence',35 .64% ± 5 .90% for'Oral sentence',and 47 .12% ± 4 .96% for'Oro-nasal sentence're-spectively in the old material .There were significant differences between males and females through materials .The nasalance gender score differences showed that females were bigger than males (P<0 .01) .This study found a cor-relation between the new and old materials :'Nasal sentence'(r=0 .899 ,P< 0 .01) ,'Oral sentence'(r= 0 .850 ,P<0 .01) ,and'Oro -nasal sentence'(r=0 .851 ,P<0 .01) .The standard error difference showed that the new was smaller than the old (P<0 .01) .Conclusion The new material for nasalance evaluation has a better test validity ,and there is a high correlation between the old materials .The usage of the new material for nasalance evaluation will produce more accurate results with higher credibility .Normal female's nasalance scores were higher than males .

Objective By analyzing the graph features of fundamental frequency at different rates of/i/with continuously variable pitch and loundness made by normal adults,we could explore that the rate and gender have some impact on the graph to lay the foundation of regulating the clinical maximum counting ability.Methods Nor-mal adults of 51 (25 males,26 females were included).After each deep breathing,the subjects respectively took sustained speech/i/ with continuously variable pitch and lounolness twice at different rates of fast,medium and slow speed.Some parameters were measured byDoctor Speechat different rates of the tone/i/:Total time(T), Mean time standard deviation (MTSD),Mean wave crest (MWC),Mean wave trough (MWT),Mean frequency range (MFR),Mean frequency range standard deviation (MFRSD),comparing the speed having some effect on those above parameters with gender.ResuIts ①With the increasing rate of speech,the tone/i/of T (P<0.001), MFR (P<0.01)and MTSD (P<0.001)were significantly decreased,MWT significantly increased (P<0.001), While the MWC and MFRSD did not change significantly (P>0.05 ).②The tone /i/ of T (P>0.05 )were not effected by gender,female's MWT (P<0.001),MWC (P<0.001),MFR (P<0.001),MFRSD (P<0.01)were obviously higher than male's,while female's MTSD were significantly larger than male's (P<0.01).ConcIusion We should consider the impact of rate of speech and gender in clinical tests and values of MCA.The maximum counting capacity can be respectively tested at three different rates of speech for each subject,but only are the tone/i/of fun-damental frequency graphs with MWT,MWC,MFR,and MFRSD in normal range with corresponding speed and gender,can we get the value or can the value be valid.

Objective To analyze the impact of uterine septum on pregnancy and influencing factors on postopera-tive pregnancy. Methods 125 patients with septate uterus and bearing requirement who underwent TCRS were fol-lowed up to assess fertility outcome. The clinical data was retrospectively analyzed. Results Spontaneous abortion rate was 70.40%and 19.39%, live birth rates was 10.40%and 72.45 %in preoperation and postoperation respec-tively. The difference was statistically significant ( < 0.05). Spontaneous abortion rate in older than 35 years old group was significantly higher than that in younger than 35 years old group, but live birth rate was lower. There was no significant difference in different times of operation in uterine cavity, number of abortion and septum length and so on. Conclusions TCRS can significantly improve pregnancy outcome. The age has influence on postoperative pregnancy outcome. Abortion numbers, septum length, septal base width, intrauterine device (IUD) and hormone re-placement therapy (HRT) may have no effects.